Lesson 3 Pg. 3BACKGROUND INFORMATION Basic Human Needs Most personal services you perform for clients are just that: personal Always keep in mind the dignity of the client and his/her need to be treated with kindness and respect. If you imagine the roles being reversed and yourself being the one cared for it may help you remember this important aspect of being a companion. Basic Human Needs... To work effectively with other people, we need to understand some things about ourselves and others. No two people are exactly alike, but there are certain needs we all have in common, no matter what our age, race, economic status education, or religion. Physical or biological needs, such as food, clothing, shelter, rest and activity, avoidance of pain and instinct to escape danger are needed for our health and survival. Our psychological needs are for emotional, mental, spiritual, intellectual, and social growth and development. How well they are met will determine our sense of well-being. Our psychological needs are: love and affection shown by sensitive care and interest recognition and acceptance that promotes self-respect and self-worth (to be needed or useful). security and trust developed through consistent TLC (tender loving care), laying the groundwork for self-reliance and healthy independence. opportunities to ask for help. Communication and relationships with others help determine how we see ourselves and how we develop as unique personalities. Without such relationships, the human personality will not develop. Unmet Needs How well basic needs are met at any age determines future functioning. Individuals are negatively affected whenever basic needs are not met. They are said to be in stress. Stress may be physical, emotional, mental, social, or a combination of these. Everyone will react differently, but some common reactions to stress when basic needs are not met are: fear aggression anger regression anxiety discouragement depression physical ailments The basic needs of older people are not very differe nt from those of other age groups. Among the needs of the elderly are those things all adults need: peopl e, pets, or special possessions to love and care about; a pleasant, safe living environment, with adequate amounts of both privacy and stimulation; a nutritious diet; someone to care about them; and enjoyable and/or useful activities. Older people do not lose the need to be self-reliant, that is, to be able to make their own decisions and to be in control of their own lives.

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Lesson 3 Pg. 4Communication When people exchange information, the information is called a message. The person who communicates it is called the sender. The person to whom the information is sent is called the receiver. The roles of sender and receiver may constantly change as first one person, then the other, speaks, and hopes what is said is understood by the other person. The simpler and more exact the message, the greater the chance that the receiver will understand and interpret the message right. Most contacts between people involve speaking a message, even if the message is only good morning. But we all know that the way in which that greeting is given can convey a world of meaning to the receiver. A message, the content of a communication, may be verbal (spoken) or it may be non-verbal (not spoken). Speech and language are usually what come to mind with the word communication. Yet communication can be both in words and other ways (body language, tone of voice, the looks that go along with words, and so on). Some of these non-verbal messages may have more meaning than spoken words. If someone glares and growls at you while saying good morning, you will get a very different meaning from the one you get when someone smiles at you while saying it and throws a hand in the air. Some non-verbal communications are neutral, such as when a person points at something to show what she/he means. Communication by gestures can be very complex, such as with the sign language of the deaf. But one of the most important means of communication non-verbally is eye contact, or avoidance of eye contact. Finding out what another person belie ves is the goal of eye contact, and taking that into account may be the key to some situations. Culture and context are important in interpreting the meaning of non-verbal gestures. To most American s, looking someone straight in the eye is the only way to make oneself believable when speaking. Doing that to an employer in Japan, however, would be to insult him. In some cultures it is important to allow someone that you are communicating with his or her personal space by keeping oneself at an acceptable distance. There are ways in which a person can learn to communicate better. Communication is a learned skill. You can become sensitive to the ways messages are sent and received, and clarify the content of messages.Adapted with permission from Resource Manual: In formation for Caregivers of the Elderly by Share Bane and Burton Halpert, Center on Aging Studies, Univ ersity of Missouri, Kansas City, 1986.Effective Communication Effective communication helps us cope with stress from problems that involve other people. Good communication skills can also help in reducing loneliness. These skills help build and keep good relationships. We each have an idea of the world a model on which we base our behavior. This model of the world determines to a large degree what our experience of the world will be. It also determines what choices we see available to us. No two human beings have exactly the same experiences, past or present. When you can communicate what is inside of you effectively when you can use communication skills to show who you are to other people you can become more intimate and make your relationships better.

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Lesson 3 Pg. 5When you try out new communication skills, you go through several stages. First, you become aware that there are options. Second, there is an awkward stage of trying on new behavior that doesnt always feel right. The third stage is a very deliberate effort on your part to use these skills. While the last stage adds the new skills into your life, it also combines those skills that have been working for you all along. It is natural that in times of stress you may go back to old forms of behavior. However, if you keep practicing new communication skills, you will go back to the old ways less and less until these new skills become part of you. When you communicate, you need to show respect for each person, including yourself. Being tense or nervous is caused by being concerned about what th e other person is thinking, about his/her acceptance of you. Often, when we try to communicate, we are not really listening. Instead, we are telling others that their reality is not true. We tell them what ought to be true for them. We try to tell others they are responsible for how we feel. Sometimes we think others agree with us when they dont, or we try to pressure others into agreeing with us. Self-awareness When you have something important to communicate, either important information or having your feelings understood, you must take the time to be self aware. To be self aware is to know what you want to say and what you hope to gain by saying it. Here are some questions to ask yourself. The more you can answer, the clearer your message will be. Phase I: Focusing on a Specific Topic 1.What issue or situation am I talking about? 2.Who is/was involved? 3.When and where did this or will this take place? Phase II: Focusing on the Pieces of Information I Have 1.What did I see? 2.What did I hear? 3.What were my thoughts, based on what I saw and heard? 4.What feelings did I have? 5.What would I like? 6,What action can be taken? These questions will help you become clear in all communication, but they are really useful when something is important and/or emotional.

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Lesson 3 Pg. 6When something is important and/or emotional, it helps to write out your concerns on a sheet of paper and take it with you when you speak to the other person. Pick a time to talk when both persons are willing to talk and listen. This should be a time when neither person is in a hurry. Sending a Message The language of the mind is pictures. This is very important to remember when we deal with someone else. We are sending and receiving pictures. If you want something to be understood, you need to paint the word picture as clearly and accurately as you can. Most people cant read your mind! If what you have to say is worth saying, isnt it worth taking a few seconds to get a clear picture and to know why you want to communicate your picture to that other person? An idea that many of us have is that you always know what I mean and I always know what you mean. This isnt so. Even by painting a clear picture with your words, it does not mean that your message will be clearly understood. We use words to paint our pictures, yet each person interprets those words in different ways. The meaning of words are in peoples minds, not in the words they say. You need open, honest communication to build and keep good relationships. Too often people keep their opinions and feelings from each other. Adult sons and daughters may say what they think their parents want to hear so as not to upset them. This can create distrust. The use of I messages can help make honest communication. The person speaks from personal feelings and identifies both the specific behavior or situation of concern and its effects on him or her. An example is: Dad, Im worried about your safety living alone. You have been found by neighbors wandering outside at all hours of the night. Im afraid you will be hurt and not found for hours or days. This message is more likely to be listened to and addressed than a You message. Some examples of You messages are: You must move so someone can watch you. You should eat better. You never listen to anyone else. You shouldnt feel angry. These messages can make the other person defensive. They create resistance.

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Lesson 3 Pg. 7Self Awareness/Sending A Message Communication is a vital part of our everyday lives. Communication is an exchange of information often called the message. Its been estimated that 70-80% of our lives is spent in communicating. Just how we spent that time is interesting: 9% of the time is spent in writing, 16% is spent in reading, 30% is spent is speaking, and 45% is spent in listening. The receiver of the communication holds the key as to whether the message has been received properly. How often have you thought you understood what some one said, but found out later that you didnt interpret the right message? We have all probably been in that position. Lets do an activity you might have done before. Were going to pass a message around the circle by whispering the message into your neighbors ear. When the message has gone all the way around ask the initiator to repeat the message to the whole group and the final receiver to repeat the message passed. Did the message change? Most times, the message changed dramatically by the time it came back to the original sender. But, I can hear it now, we all know how to listen. But we dont! We have the capacity to speak at a rate of about 125 words per minute. Our brains, however, can understand at a rate of 400 words per minute. What do you think happens in between the 125 words being spoken and the 400 words we can understand? You probably have experienced what happens. I know I have. I can think of all sorts of other things while someone is speaking and still catch what the person is saying. I may not be giving total attention to whats said, particularly if I am in a discussion which is uncomfortable. I try to think of my answer before the other person stops talking. This can be a severe block to effective communication since I hold the key as to whether the communication has been effective. Remember: a communication occurs only when the receiver actually gets the message being sent by the sender. Active Listening Active listening is a communication skill to help people solve their own problems. The listener knows that the sender needs to communicate. The listener takes an active responsibility to understand the content and feeling of what is being said. This is often done by putting himself/herself in the other persons shoes and letting the sender know he understands. Active listening can show acceptance and trust as well as help in problem solving. The listener can learn what the other person means and how she/he feels about something. The listener should communicate warmth and feeling about the senders message. Active listening should not be used when there is not time to deal with the situation or when a person is only asking for facts. Active listening is not a cure-all for problems in a relationship. However, the acceptance that you give through active listening may help to break down old barriers and allow a new relationship to develop.

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Lesson 3 Pg. 8LESSON PLAN Part 1: Meeting Basic Human Needs Introduction: Human beings have basic human needs regardless of their age. It is important to understand and consider these needs as we work with people. DO: Brainstorm with the group for their basic needs. Distribute Handout A, Basic Human Needs. Show transparency created from Handout A, Basic Human Needs for discussion of physical and psychological needs. Brainstorm with the group for what happens when needs are not met. Ask participants to cluster themselves in groups of three or four. Each group will use Handout B, the Examples of Human Needs activity sheet and discuss the four points about each of the situations reported. After 8-10 minutes ask one person from each group to report back to the overall group. REFLECT: What physical or psychological needs of the persons in the scenario examples are not being met or may need to be met? Might an elder companion be needed? What specific activities could an elder companion do to help meet the needs of these families? What basic human needs physical and psychological would the elder companion be meeting if the activities specified were implemented? APPLY: How will you use this information in your work with the elderly?

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Lesson 3 Pg. 9 Handout ABASIC HUMAN NEEDS Physical or biological needs are needed for our health and survival. These include: Food Clothing Shelter Rest and activity Avoidance of pain Instinct to escape danger Psychological needs are needed for emotional, mental, spiritual, intellectual, and social growth or development. These include: Love and affection Recognition and acceptance (to be needed or useful) Security and trust Opportunities to ask for help

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Lesson 3 Pg. 10Handout BEXAMPLES OF HUMAN NEEDSScenarios: 1.A 73-year-old mans wife died a few days after celebrating their 50th wedding anniversary. Not only does the husband need help in coping with dressing and cooking, he is also lonely. 2.A widowed 72-year-old woman with a broken hip has no family but wants to stay in her own home. 3.An 80-year-old man wants to continue living in his own house but can not manage the home maintenance. 4.A 69-year-old woman has moved to town to be closer to her daughter who works all day. Discussion Questions: 1.What physical or psychological need(s) are not being met or may need to be met in each scenario? 2.Would an elder companion be helpful? 3.What specific activities could an elder companion do to help meet the needs of these families? 4.What basic human needs physical and psychological would the elder companion be meeting if the specific activities listed for number 3 are implemented?

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Lesson 3 Pg. 11LESSON PLAN Part 2: Self Awareness/Sending A Message Introduction: During this session we will focus on aspects of communication. Ask the class What is communication? Write the responses on newsprint. Communication is a vital part of our everyday lives. Communication is an exchange of information often called the message. Its been estimated that 70-80% of our lives is spent in communicating. Distribute Handout C, How Communication Time is Spent Just how we spent that time is interesting: 1.9% of the time is spent in writing, 2.16% is spent in reading, 3.30% is spent is speaking, and 4.45% is spent in listening. The receiver of the communication holds the key as to whether the message has been received properly. How often have you thought you understood what some one said, but found out later that you didnt receive the right message? I think we have all been in that position. Lets do an activity you might have done before. Were going to pass a message around the circle by whispering the message into your neighbors ear. When the message has gone all the way around ask the initiator to repeat the message to the whole group and the final receiver to repeat the message passed. Did the message change? Most times, the message changed dramatically by the time it came back to the original sender. But, I can hear it now, we all know how to listen. But we dont! We have the capacity to speak at a rate of about 125 words per minute. Our brains, however, can understand at a rate of 400 words per minute. What do you think happens in between the 125 words being spoken and the 400 words we can understand? You probably have experienced what happens. I know I have. I can think of all sorts of other things while someone is speaking and still catch what the person is saying. I may not be giving total attention to whats said, particularly if I am in a discussion which is uncomfortable. I try to think of my answer before the other person stops talking. This can be a severe block to effective communication since I hold the key as to whether the communication has been effective. Remember: a communication occurs only when the receiver actually gets the message being sent by the sender. Distribute Handout D, What Happens Between Speaking and Hearing Show transparency created from the handout. Self-Awareness is a very important element of communication. Lets try being aware of ourselves for a few minutes. Get comfortable in your chair and close your eyes. Keeping your eyes closed, focus your attention on what is going on around you, in the room, and outside. Say to yourself, I am aware of a car passing, birds singing, the wind blowing. (Allow 2 minutes.)

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Lesson 3 Pg. 12This exercise helps you separate and appreciate the difference between your inner and outer worlds and your reaction to them. DO: Self-awareness and Communication Exercise. Lets take this information and apply it to a real situation in the life of an elderly person. I will be reading two short scenarios or stories. Id like you to record your reactions to them. I have a sheet on which you can write your reactions as I read. Distribute Handout E, Self-Awareness and Communication Read Stories 1 and 2, (slowly and clearly), and encourage participants to record their responses. REFLECT: What were some of your responses? What were you feeling? What would you say if you were the daughter? (Allow time for several different responses.) DO: With that information in mind, Id like you to consider the stories once more. This time, think ahead about the outcome you desire before you plan your response. Take a few minutes to remember both stories. Then, fill out Sending A Message (Handout F). REFLECT: How are your responses different this time? What difference did it make when you thought about outcomes and desired results before responding? (Allow for discussion. Elicit several examples.) Review Handout F, Sending A Message Practice using I messages. Instructor note: This unit needs to be reviewed thoroughly. Familiarize yourself with its content. Note particularly that in the self-awareness exercise you are trying to get participants in touch with the thoughts and feelings of caregivers This is sometimes difficult. Participants may want to problemsolve or come to the defense of the older person.

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Lesson 3 Pg. 13 Handout CHOW COMMUNICATION TIME IS SPENT 9% of our time is spent in writing 30% of our time is spent speaking 16% of time is spent in reading 45% of our time is spent is spent in listening

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Lesson 3 Pg. 14 Handout D WHAT HAPPENS BETWEEN SPEAKING AND HEARING

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Lesson 3 Pg. 15STORY ONE Sam Long, a 76-year-old man, lives with his wife, Sarah, in their own home. They have been invited by their daughter to go to Christmas dinner at her house. All the family plans to gather there because the daughters house will accommodate the most people. Sam is concerned about going because the bathroom is on the second floor. Lately, he has been experiencing some mental confusion and is not always sure of whats going on. Because of some recent hearing loss, he is sometimes not sure of what is being said to him. The day befo re Christmas, his daughter checks in to confirm what time she will pick up her parents on the following day. Her father says that he is not going. She asks, Why? His response is, Im too old for that stuff. I want to be here in my own home. The daughter becomes upset and says, But Dad, everyone wants to see you. Its all planned for my house! I dont understand whats wrong. Weve done this every year for the past eight years. Sam says, I dont care. Im sick. I can do what I want. The daughter responds by saying, Well, whats wrong? Are you having more problems? Do you need to see a doctor? What can I do so that you will be with the family tomorrow? Allow time for participants to write down their responses. Encourage discussion.

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Lesson 3 Pg. 16Note: In reading this second story, keep in mind that Jane is honestly concerned for her mothers safety. STORY TWO Barbara Simmons, a woman in her early 80s, has begun to have problems with her vision. She also is finding herself with limited mobility. Up until now she has been involved in doing craft projects and has spent a great deal of time reading. Her house is full of craft supplies for various projects which have not been completed. Her daughter, Jane, thinks that the house is too cluttered and creates a safety hazard. She is worried about the boxes stacked in the hall in case of a fire. On a visit one Friday, the daughter says, Mother, all this craft stuff is really getting to be a hazard and is in the way. I think you should get rid of it. I can take it and have a garage sale. Or, I could give it away so it wont be in the way. Barbara responds by saying, You wont touch my things! This is my house, and these are my things. It just so happens that I have spent a lot of money on these. Ive been saving these for my old age to give me something to do now that I cant get out much. Jane says, but mother, thats crazy! You cant see well enough to use half this stuff. Youll never use all this. It makes the house look a mess! Allow time for the participants to write down their responses. Encourage discussion.

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Lesson 3 Pg. 17 Handout ESELF-AWARENESS AND COMMUNICATIONStory One My thoughts and feelings which were triggered when listening to this story were: Story Two My thoughts and feelings which were triggered when listening to this story were: If I were the daughter, I would respond by saying: If I were the daughter, I would respond by saying:

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Lesson 3 Pg. 18 Handout FSENDING A MESSAGEStory One What result would I want from my conversation with my father? Story Two What result would I want from my conversation with my mother? If I were the daughter, I would respond by saying: If I were the daughter, I would respond by saying:

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Lesson 3 Pg. 19LESSON PLAN Part 3: Active Listening Introduction: Do the Receiving Messages exercise as an introduction. (Distribute Handout G, Receiving Messages.) After the group has discussed the exercise, give an overview of active listening. Active listening is important in successful communication. (Familiarize yourse lf with this material. You may want to use the following outline for your own brief talk Feel free to amplify this outline. However, do not make the talk too long. One or two personal examples can be useful.)Active listening involves giving the speaker your undivided attention.The focus of active listening is on understanding the speakers intentions.Checking that you are really understanding what the speaker says is helpful. You can do this be reflecting back your understanding and by asking questions.Some behaviors interfere with good listening. These behaviors include, for instance, dreaming, advising, sparring, being right, and placating. Show transparency created from Handout H, Behaviors Which Interfere With Good Listening and distribute the handout. DO: Stating and Listening for Differences Exercise. This exercise gives the experience of trying to listen to another person even when you have your own strong opinion. It also gives the experi ence of using self-awareness when sending a message. Give the participants the exercise on Stating and Listening to Differences, (Handout I). Id like you to go through this outline with one person taking one point of view on an issue and the other person taking a different point of view. Spend a minute deciding who will take each side and another minute collecting our thoughts. Then youll have just five minutes to read through the outline. Jot down your own thoughts. You do not have to use the exact words of the exercise but follow the process.

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Lesson 3 Pg. 20REFLECT: What was this exercise like for you? Ask the observers to report what happened. What did it help you to do that you do not usually do? What did you learn about dealing with differences? (Allow time for discussion.) DO: Give each of the participants a copy of Handout J, Suggestions for Active Listening Make a few introductory comments about active listening. Have two of the participants role play the active listening exercise. REFLECT: What does this exercise show about listening? What was important for the listener to do in this situation? Did the listener listen actively? APPLY Have the group discuss what might have resulted if the listener had not listened actively. Some possible comments might include: The heat might have been turned to the wrong temperature; the wrong sweater might have chosen; the tea would not have been prepared properly. DO: Physical/Emotional Blocks to Communication Divide the participants into groups of 2-3 people. Give each group a copy of Handout K, the Physical/Emotional Blocks to Communication worksheet. They are to read each situation and offer possible approaches to increase communication. Allow 10-15 minutes. Have groups share their ideas and suggestions. Distribute Handout L, Physical/Emotional Blocks to Communications and discuss the ideas presented.

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Lesson 3 Pg. 21REFLECT: What are some of the barriers to communication with the elderly? What did you discover about communicating with the elderly? APPLY: Think back over all of the activities of this session on Communication. (Allow a few minutes). Choose one thing that you learned today which you can practice and share with a friend over this next week. (Allow 1-2 minutes.) Lets go around the group and hear what each person has chosen to practice and share. (Allow 5 minutes for a quick report.) How will you use this information in your work as an Elder Companion?

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Lesson 3 Pg. 22RECEIVING MESSAGES EXERCISE Listening intently is very hard work. How often have you been in a situation when you had to listen very closely? How did you feel when it was over? Tired? Worn out? Were you tired both physically and mentally? Lets do a listening exercise called the Captain Says. Take out a sheet of paper and a pencil. Do what the Captain Says! Trainers Note: Be sure to keep an even, though silent, 4 beat cadence between each number to ensure exact time between instructions. Often, participants will be convinced that you have sped up the instructions. The Captain Says: On the top of the left-hand side write the name of the country you live in at present. Along the right-hand side write the name of the state you live in at present. Draw a line from the top right-hand corner to the bottom left-hand corner. Draw a line from the center of the top to the center of the bottom. Fold your paper along the center line with the left side over the right side. Now draw a diagonal line from the top left corner to the bottom right corner and write your first name three times on the diagonal line. Fold your paper into thirds and hand it to the person next to you. Following the Exercise Say to the participants: Open the sheet you have. Raise your hand if you think its correct. (Usually about 25% of the participants will do everything correctly.) Why do you think so many people didnt do this exercise correctly? Would anyone have done better if this were an important group task or item of business, or if it was a situation of listening to a troubled individual? What would have helped? Discuss.

Lesson 3 Pg. 25Handout IStating and Listening to Differences ExerciseThis is a three-person exercise. Two people will be involved in the discussion and one person will be the observer. Decide who will be the observer. The two doing the discussion should choose a topic or issue about which they disagree and about which th ey both have some strong, differing opinions. Take a moment to clarify your thoughts about this issue to yourself. Then begin the exercise. Person A: I would like to tell you what I think and feel about ______________________ . Person B: Let me make sure Im understanding you correctly. Youre saying . . (Repeat what person A said in your own words.) Is that correct? Person A: Let person B know if he or she has paraphrased correctly. Do this by saying yes or no or adding some clarifying information. Person B: Continue to re-state what person A is saying in your own words until person A says that you understand correctly. Observers Notes: Once Person A says that Person B has understood the message sent, the process can now be reversed as Person B states his or her ideas and opinions while Person A paraphrases.

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Lesson 3 Pg. 26 ACTIVE LISTENING EXERCISE This exercise focuses on a conversation between a speaker Mrs. Smith (an elderly client) and a listener Mary Ann (Mrs. Smiths elder companion).SpeakerListener Mrs. Smith: Mary Ann, Im having a chill, will you please turn up the heat. (Mrs. Smith shivers slightly and rubs her arms.)Mary Ann: Of course, Mrs. Smith. I am sorry that you arent comfortable. What temperature is right for you?Mrs. Smith: I think you had better turn it up to about 78o.Mary Ann: All right, I will turn it up to 78o.Mrs. Smith: Maybe I had better put on a sweater, too.Mary Ann: Ill bring you a sweater, Mrs. Smith.Mrs. Smith: My old blue sweater is very comfortable, do you think you can find it?Mary Ann: I know right where your blue sweater isits on the chair in your bedroom. (Mary Ann points toward the bedroom.)Mrs. Smith: Is it clean, Mary Ann? I dont remember when it was last washed.Mary Ann: I washed it a few days ago, so it should be all-right.Mrs. Smith: I would like for you to do one more thing for me if you will.Mary Ann: Ill be glad to, if I can.Mrs. Smith: I would love to have a cup of hot tea with cream and sugar, but no lemon, please. Just a little bit of cream and one teaspoon of sugar. Would you like to have a cup of tea, too?Mary Ann: A cup of tea with a little cream and one teaspoon of sugar, but no lemon, is that right? Id like to have a cup, but I like my tea with lemon and no cream or sugar.Mrs. Smith: (After Mary Ann has turned up the heat, gotten a sweater for her to wear, and prepared her tea). Thank you Mary Ann, you are so kind to me.Mary Ann: Do you feel better now? Are you warmer?Mrs. Smith: Oh, yes. You have taken such good care of me.Mary Ann: If you need anything else, please tell me and I will be happy to help.

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Lesson 3 Pg. 27Handout JSUGGESTIONS FOR ACTIVE LISTENING An active listener does not respond with his/her own idea or opinion, but reflects back to the sender what she/he hears being said. Some things to listen for are: the speakers feelings, values, attitudes, judgements and needs. Be aware of the speakers body language, facial expressions and voice tone. Use body language of your own that encourages the speaker to talk. Try to understand the others viewpoint. You dont have to agree with it. Know something about the other persons viewpoint and values. Realize that it is all right for someone to think and feel differently than you do. Ask questions to clarify. Give feedback to confirm understanding.

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Lesson 3 Pg. 28 Handout KPhysical/Emotional Blocks to Communication WorksheetFrom your experience with an elderly person, give suggestions for improving communications with each person. Hearing Loss: Mr. Jones has lost his hearing and does not participate in conversations with the family. Vision Loss: Mrs. Smith has lost most of her vision and gets very frustrated and decides not to try to communicate. Withdrawal/Depression: Mr. Johnsons health keeps declining and he is depressed. It is easier to withdraw than to try to be part of life. Anger: Mrs. Brown is angry over the direction her life has taken in these later years. She is in a nursing home and rarely has visitors.

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Lesson 3 Pg. 29Handout LPHYSICAL/EMOTIONAL BLOCKS TO COMMUNICATION Physical problems, such as hearing or vision impa irment, or emotional problems, such as anger or depression, can be blocks to communication. Some guidelines are given below to help reduce these physical or emotional blocks. Hearing Loss 1.Be sure the person to whom you are speaking knows that you are talking. 2.Stand or sit in front of the person. 3.Use gestures to help show the verbal message. 4.Keep sentences as short as you can. Vision Loss 1.Make sure you or your materials are in the persons field of vision. 2.Label objects with large lettering. 3.Keep the visual field simple and uncluttered. 4.Use bright colors and strong contrasts such as black lettering on a white background. 5.Approach the person slowly, and announce yourself to keep from scaring the person. 6.Communicate through other senses talking, touching. Withdrawal or Depression 1.Talk to the person as much as you can about real things. 2.Give realistic praise about things the person does well. 3.Talk about the things the person enjoyed in the past and things to which the person can realistically look forward. 4.Get the person to do things which will result in success. 5.Accept the persons feelings of sadness or fear as real.

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Lesson 3 Pg. 30Anger 1.Let the person talk without taking anger personally. What the person says or feels needs no response from you. 2.Let the person be upset or angry. 3.Let the person know you care; say back in your own words what you heard the person say. 4.Give the person time to feel understood before you try to resolve any problem.